Wednesday, May 31, 2017

Here's a forthcoming article in Transplantation, interesting for both what it says and who says it.

The authors include prominent transplant professionals at UCLA (which is an important, innovative and productive kidney transplant center), and also the rising-star economist and matching theorist Marek Pycia. I recall a time when collaborations between economists and transplant professionals was unusual, and so I'm glad to see new collaborations of that sort arise.

The paper itself is about taking future care of young kidney patients who may need a (second or third) kidney donation later in life. The NKR and UCLA are implementing a voucher system that would allow a donor (e.g. the young patient's grandparent, or parent) to donate as a non-directed donor today, on behalf of a specific, current kidney patient, in return for a commitment that best efforts would be made to end some future kidney exchange chain with a chain-ending kidney for the designated patient, when the need arises.

TransplantationPublished Ahead of Print DOI: 10.1097/TP.0000000000001744AbstractBackground: The waiting list for kidney transplantation is long and growing. The creation of :vouchers" for future kidney transplants enables living donation to occur when optimal for the donor and transplantation to occur later, when and if needed by the recipient.Methods: The donation of a kidney at a time that is optimal for the donor generates a :voucher‘" that only a specified recipient may redeem later when needed. The voucher provides the recipient with priority in being matched with a living donor from the end of a future transplantation chain. Besides its use in persons of advancing age with a limited window for donation, vouchers remove a disincentive to kidney donation, namely, a reluctance to donate now lest one‘s family member should need a transplant in the future.Results: We describe the first 3 voucher cases, in which advancing age might otherwise have deprived the donors the opportunity to provide a kidney to a family member. These 3 voucher donations functioned in a nondirected fashion and triggered 25 transplants through kidney paired donation across the United States**********See my earlier post:

Here's the web page and program in Italian and in English (click on the Union Jack)

Here's a page describing the three events that I'll take part in on June 1 and 2. In the first I'll speak about market design and kidney exchange, in the second about my book, which recently came out in Italian, and the third event will be a panel discussion of repugnant transactions:

To what extent can facilitating the bringing together of supply and demand for organs save human lives and reduce health inequality? In particular, is it possible to organise the exchange of kidneys efficiently, taking into account ethical and regulatory restrictions? To what extent is this exchange between rich and poor countries manageable on a global scale?

In Italy, as in many other countries, the demand for transplant organs exceeds supply, and the gap is increasing over time. Is it possible to consider the idea that providing monetary payment for donors or other forms of exchange, as takes place in other countries, may contribute towards filling the gap between supply and demand? Is there not a risk of introducing unacceptable forms of exploitation and unfairness?

Saturday, May 27, 2017

Historian of Economics Beatrice Cherrier blogs about the two Golden Goose Awards that have been made for various parts of market design (in 2013 and 14), and suggests that more deserving topics could have been picked...

Thursday, May 25, 2017

Government funding of science is important, and at risk. Here's an opinion piece that ran yesterday in Alabama, which seeks to bring some of the direct benefits in Alabama to the attention of Alabama's citizens and representatives in Washington (using the active kidney exchange program in Alabama as an example).

"As the Director of the Incompatible Kidney Transplant Program at UAB and a Nobel Prize winning economic researcher, we have seen first-hand the power of science to connect those suffering with disease with vital cures.

We applaud Senator Shelby as a leader of the Senate Appropriations Committee, and Representatives Aderholt and Roby on the House Appropriations Committee, as well as all of the Alabama Congressional delegation on their work to support vital R&D investments in a bipartisan way.

We are hopeful that leaders will once again demonstrate that funding America's future innovation is a bipartisan imperative. "

Wednesday, May 24, 2017

Google translate:
Results and challenges of the new school admission system

"The implementation of this new system counted on the participation of all the relevant actors. Schools actively informed parents about the various aspects of their educational programs and their vacancies. After accessing this information (either in person or via the web platform designed by Mineduc), the parents declared a list of preferences of the schools in which they wanted to enroll their children . The system is designed so that they express their preferences about different establishments in an honest and transparent way.

Many colleges have more applicants than quotas. To decide which students will be admitted to a facility, applicants are listed. This list respects the priorities indicated in the Law of Inclusion and guarantees equal opportunities by solving ties in a random manner.

Allocation mechanisms similar to those implemented in Magallanes are used in several countries around the world, highlighting the cases of the USA. (Boston and New York, among others), Holland and Finland. In each case, the DA algorithm must solve local demands that make each implementation unique and interesting. In Chile, for example, the law establishes priority criteria for applicants, so the allocation algorithm must give preponderance to siblings and children of officials, as well as those students considered to be priority because of their socioeconomic situation.

Our review of the 2016 process is positive. 3,580 students participated in two rounds of application: 3,147 exclusively in the main round, 222 in the second round and 211 in both. Of these applicants, in the main round, 1,959 (58.3%) were assigned to their first option, while in the second round this number reached 357 (82%). In the full process 3,107 students were assigned to one of their preferences, while 258 were withdrawn from the process. International experience shows that these numbers are positive. In New York, for example, in the process of admission to secondary education in 2006, about 40% of students were assigned to their favorite school.

One of the challenges for the next implementations is the simplification of the different stages of the process. Likewise, it is important to inform parents and guardians to motivate them to use the new admission system and, in this way, increase the chances of their children staying in a school that satisfies them. Our challenge is to scale this system to make the school assignment of all children in Chile."

"Yet by the time of his death, that surgery — with its horrific outcome — had taken its place in the annals of medical law. It had led to a landmark court ruling that fundamentally transformed how doctors deal with patients in evaluating the risks of potential treatment.

“This is probably one of the handful of most significant medicolegal cases in United States history,” said Jacob M. Appel, a doctor and bioethicist.

"The ruling, by a federal appeals court in Washington in 1972, declared that before a patient provided informed consent to surgery or other proposed treatment, a doctor must disclose the risks, benefits and alternatives that a reasonable person would consider relevant.

"Previously, the onus of soliciting that information had rested with the patient, and any description of risks was provided at the doctor’s discretion. A doctor had been considered negligent only when treatment was administered against the patient’s wishes.

“It would not be an exaggeration to say that the opinion is the cornerstone of the law of informed consent” to medical treatment, “not only in the United States, but in other English-speaking countries, too,” said Prof. Alan Meisel, who teaches law and psychiatry at the University of Pittsburgh School of Law."

Abstract: Concerns regarding the potential for broken chains and reneges within kidney paired donation (KPD) and its effect on chain length have been previously raised. While these concerns have been tested in simulation studies, “real world” data has yet to be evaluated. The purpose of this study was to evaluate the actual rate and cause of broken chains within a large KPD program. All patients undergoing renal transplantation through the National Kidney Registry from 2008 through May 2016 were included for analysis. Broken chains and loops were identified. A total of 344 chains and 78 loops were completed during the study period yielding a total of 1,748 transplants. Twenty broken chains and one broken loop were identified. The mean chain length (# of transplants) within broken chains was 4.8 compared to 4.6 of completed chains (p=0.78). The most common causes of a broken chain were donor medical issues incurred while acting as a bridge donor (n=8), donors electing not to proceed (n=6), and kidneys being declined by the recipient surgeon (n=4). All recipients involved in a broken chain have subsequently received a transplant. Based on the results broken chains are infrequent, rarely due to lack of donor motivation, and have no significant impact on chain length.

Here's a paragraph that summarizes the main point:
"Ultimately, there just are not enough good schools to go around. And so it is a system in which some children win and others lose because of factors beyond their control — like where they live and how much money their families have."

The story follows several students at a middle school in the Bronx:
"The Times spent months following the high school application process at Pelham Gardens, where families do not have the advantages that routinely open doors to the city’s best schools. Many families are new to the country, and most are poor."

Parag Pathak (who played a critical role in organizing the NYC high school match--see e.g. here and here) wrote a letter to the NY Times summarizing his reaction to the story. As it appears that the Times won't publish the letter, he gave me permission to reproduce it:

"May 5, 2017

In
“The Broken Promises of Choice in New York City Schools,” Elizabeth Harris and
Ford Fessenden miss a key point in describing the New York City High School
choice system. The choice system does not create good schools. It exists
because there aren’t enough good schools.

I
worked with NYC DOE to design the choice system described by authors.
By any objective measure, this system provided better access to schools
than the one it replaced. Without a comparison to the old system, Harris
and Fessenden’s description of choice outcomes is misleading. In the old
system, half of applicants from Pelham Gardens (zip code 10469) were assigned
to choices they did not rank; in 2003, that number drops to 23%. Under the new
system, students from that neighborhood also travelled two miles further to
schools they wanted. Across the city, the new system allows more kids to
go to schools they ranked and the benefits were largest for those most likely
to be administratively assigned, like those in Pelham Gardens (see, http://economics.mit.edu/files/10633.
This is not to say the process is perfect and couldn’t be improved.
But it is foolish to expect the process to produce miracles, without changing
the set of school options.

A
broader premise of the article is that schools with highest test scores and
graduation rates are indeed “the best.” Our research, including on NYC’s
exam schools (http://economics.mit.edu/files/9773),
strongly suggests otherwise. Naïve discussions of school quality and the
role of school choice confuse efforts to improve school quality, where our
attention should be devoted.

Parag
Pathak

Carlton
Professor of Economics, MIT"

********************

For reference, here's the 2003 NY Times story that covered the school choice system when it was introduced:

Friday, May 19, 2017

Why San Francisco needs a full-time school boardBy Gail Cornwall, May 17, 2017 "Ever wonder why the pace of change in public education falls somewhere between inching and crawling in arguably the most progressive, innovative city in the world? San Francisco Unified School District’s red tape and lack of resources are to blame, but there’s also a story of unpaid workers, organizational mutiny and missed opportunity.Here’s an example: In 2009 the school board set out to redesign its method for assigning students to schools. Though the topic sounds dry, matching thousands of children to seats at more than a hundred programs — while taking into consideration parental preference, geography, diversity and more — involves the sexiest corner of economics: game theory.Luckily, the board had the assistance of a group representing Harvard, Stanford, Duke and MIT. Nobel Prize winner Alvin Roth, Muriel Niederle, Clayton Featherstone and others proposed helping to create, monitor and adjust a cutting-edge algorithm for free. In March 2010, the board voted unanimously to take the offer.But that September, district staff sent Roth’s team an email amounting to “Thank you, goodbye.” District officials had decided to instead “develop software to implement the new design on their own,” Roth reported.Today, the state of the district’s homegrown assignment algorithm, known to parents as “the lottery,” is described by board member Mark Sanchez as “broken” and “untenable,” and by board member Rachel Norton as “probably the biggest policy issue that our community engages with us on.”Neil Dorosin directs the Institute for Innovation in Public School Choice, a nonprofit Roth and his team formed. When I recently asked Dorosin what kind of personnel would be needed to create an effective school assignment algorithm, he said, “Either a mathematician or an economist who knows about algorithms, and … a software engineer who could operationalize it. I would be stunned if they have that.”Those who shared these concerns back in 2010 called on district staff to explain themselves. Despite making a pledge to the board to disclose the algorithm developed in-house, by March 2012 staff still hadn’t issued “a complete enough description to [know] … if they in fact implemented the plan … the board adopted,” said Roth.Lack of compliance with board directives sounds crazy, but Sanchez, who served on the board from 2001 to 2009 and won re-election in November, said it happens all the time. “There are so many examples,” he said.How could that be possible? Because board members each receive “about $6K a year — and everyone has a full-time job doing something else — they’re just too busy to check in and cajole, Sanchez said. The only thing the board really can do, he said, is fire the superintendent when “a lot of that piles up.”That’s why Sanchez and San Francisco Supervisor Jane Kim have discussed putting forward a ballot measure to increase school board member compensation. Sanchez said it would give board members “the average beginning pay for a teacher in the Bay Area ... probably ending up at around $45,000” (drawn from the city’s budget, rather than the school district’s). Following the model adopted by Los Angeles in 2006, the full amount would be available only to those who forsake other employment, he said.Meanwhile, parents fret over the lottery. The long, complex application process — where paperwork is submitted in person in January and decisions are issued in March, then again in May, through three more rounds of supplication and the first two weeks of school — fails low-income families who lack the time or bureaucratic savvy to effectively engage. Those who do manage to navigate the process, one emotional parent told the school board committee Monday night, often find the experience “time-consuming, frustrating and stressful.” Raman Khanna, a member of the Ulloa Elementary School PTA, referred to another outcome: professional “flight.” Because of the lottery, he said, “a lot of the colleagues that I talk to … leave the city or they go to private school.”Roth’s and Dorosin’s organization has worked with cities across the country to use data and technology to improve school assignment. Dorosin said the nonprofit’s modest fees are often covered by outside grants and other funding. This March they invited SFUSD board members and district officials to reach out again.The response? The board committee announced Monday it would “not be taking action,” and district staff proposed two timelines for reform: one would give the board two years to articulate a new direction for the assignment system; the other, labeled “if policy development moves quickly,” would still give them a full year to do so and then another 18 months for district staff to implement it. Tommy Williams, a parent who works for the U.S. Army Corps of Engineers, said: “The fact that we’re talking about the 202[0] or 2021 school year is very frustrating.”Board members could start meeting with national experts with just days’ notice to hash out a broad-strokes plan, but that won’t happen until the fall. “It’s clearly an urgent issue,” Sanchez said, “but it’s one of many, many things that we have to deal with. ... We had to hire a superintendent, and now we’re involved in negotiations for the contract so we wanted to focus on that.”Rionda Batiste, co-chair of the district’s African American Parent Advisory Council, won many approving head nods at Monday’s meeting when she said: “I don’t understand why this is something that cannot happen simultaneously.”“If we really wanted to speed things along,” Sanchez told me, “we’d have more meetings. Intuitively, we all know [paying board members] would make things move faster.”

Nationally, school board compensation is all over the board. Connecticut pays nothing, while Florida’s lowest paying county, as of 2014 reportedly offered $24,290 a year. According to the National School Boards Association, approximately 75 percent of small-district school board members serve as volunteers while around 40 percent of large-district ones receive a “modest salary.”This divide makes sense, because there’s much more work to be done in a district with 50,000 students than one with only a few hundred. When being an effective board member requires a full-time commitment from someone who must already work full-time elsewhere, “it’s a structural problem,” Sanchez said.A second one resurfaced at Monday’s meeting. Orla O’Keefe, the district’s chief of policy and operations, told the board: “We need a larger number of staff with the technical skills and knowledge needed to complete assignment runs,” including to “[e]xplore leveraging district ... online registration functionality with a potential online application pilot.” In other words, while the board takes its time deciding what major changes to make, district staff propose once again building in-house. Meanwhile, a Nobel Prize-winning economist — and the tools his team has honed — wait in the wings.Maybe instituting board salaries can buy our elected representatives the time they need to pursue public-private partnerships that bring expertise and manpower to the task of matching students with schools. Hopefully, this time it will be with the support of district staff, such as newly anointed Superintendent Vincent Matthews who, calling the meeting “democracy in action,” said Monday he’s “looking forward to moving this forward.”Until then, Sanchez said, “It’s in a holding pattern.”

"Former D.C. Public Schools chancellor Kaya Henderson routinely helped well-connected parents — including two senior aides to Mayor Muriel E. Bowser (D) — bend or break the rules of the District’s notoriously competitive school lottery to enroll their children at coveted schools, according to a confidential report obtained by The Washington Post.

The report, based on an investigation by the D.C. Inspector General’s Office, describes in remarkable detail how Henderson used her power as head of the school system to place the children of those with political clout at campuses they could not otherwise access through the random lottery, which every year leaves thousands of families on waiting lists for their desired schools.

Inspector General Daniel Lucas found that Henderson misused her authority by giving preferential treatment to seven of 10 people who requested special school placements for their children during the 2015 lottery season. The investigation did not examine the rest of Henderson’s tenure from November 2010 to September 2016.

Henderson openly acknowledged in interviews with investigators that she gave special treatment to the children of government officials. Asked about the help she gave City Administrator Rashad M. Young, a top Bowser cabinet official whose salary is $295,000, Henderson said D.C. officials “do not necessarily get paid as much as we should.”

The former chancellor bestowed such favors even as she dismissed pleas for special consideration from those with less influence, such as a deaf Vietnamese immigrant whose request that her daughter be allowed to attend a school where she could practice sign language was rejected.

Tuesday, May 16, 2017

Professor Bob Reed at U of Canterbury points me to The Replication Network, a website he co-founded with Dr Maren Duvendack of U of E. Anglia to promote replication in Economics, and assemble information about replication studies.

See also their paper and the others in the Papers and Proceedings (May 2017) issue of the American Economic Review, which begins with a section on replication:REPLICATION IN MICROECONOMICS